Surgical access assembly and method of use therefor

ABSTRACT

A surgical access assembly includes an access port and a seal anchor. The access port includes a proximal ring, an intermediate ring, a distal ring, and a sleeve defining a passage therethrough. In particular, the proximal, intermediate and distal rings are concentrically arranged with the passage of the sleeve, and the sleeve extends between the proximal and distal rings. The seal anchor is adapted to be at least partially disposed in the access port, and defines a lumen therethrough. At least one of the proximal, intermediate, and distal rings is configured and dimensioned to engage the seal anchor in a sealing relation therewith.

CROSS REFERENCE TO RELATED APPLICATION

This application is a continuation of U.S. patent application Ser. No.13/782,098, filed on Mar. 1, 2013, which claims priority to and thebenefit of U.S. Provisional Patent Application No. 61/615,498, filed onMar. 26, 2012, the entire contents of each of which are herebyincorporated by reference.

BACKGROUND

1. Technical Field

The present disclosure relates to a surgical access assembly, and moreparticularly, to a surgical access assembly including an access port anda seal anchor adaptably engaging each other in a sealing relation and amethod of use therefor.

2. Background of Related Art

Various surgical procedures are performed in a minimally invasivemanner. This includes forming a small opening through a body wall of thepatient, e.g., in the abdomen, and inserting a seal anchor through theopening to provide a substantially fluid-tight seal between a bodycavity of a patient and the atmosphere. Due to the relatively smallinterior dimensions of the access devices used in endoscopic procedures,only the elongated, small diametered instrumentation such as, e.g.,trocar and cannula assemblies, may be used to access the internal bodycavities and organs. In general, prior to the introduction of thesurgical object into the patient's body, insufflation gases are used toenlarge the area surrounding the target surgical site to create alarger, more accessible work area.

When compared to the larger incisions typically found in traditionalprocedures, both trauma to the patient and recovery time are reduced forprocedures involving small incisions. However, minimally invasivesurgery such as, e.g., laparoscopy, has several limitations. Inparticular, surgery of this type requires a great deal of skill inmanipulating the long narrow endoscopic instruments to a remote siteunder endoscopic visualization. To this end, hand-assisted laparoscopictechniques and procedures have been developed. These procedures includeboth laparoscopic and conventional surgical methodologies. Thehand-assisted technique is performed utilizing a seal anchor inconjunction with an access port, which is an enlarged device thatprotects the incised opening from, for example, infection andcontamination.

The maintenance of a substantially fluid-tight seal is desirable toprevent the escape of the insufflation gases and the deflation orcollapse of the enlarged surgical site. Accordingly, there is a need foran access assembly used in a hand-assisted minimally invasive procedurethat can accommodate a variety of surgical objects while maintaining theintegrity of an insufflated workspace.

SUMMARY

In accordance with an embodiment of the present disclosure, there isprovided a surgical access assembly including an access port and a sealanchor. The access port includes a proximal ring, an intermediate ring,a distal ring, and a sleeve defining a passage therethrough. Inparticular, the proximal, intermediate and distal rings areconcentrically arranged with the passage of the sleeve. The sleeveextends between the proximal and distal rings. The seal anchor isadapted to be disposed in the access port. The seal anchor defines alumen therethrough, wherein at least one of the proximal, intermediateand distal rings is configured and dimensioned to engage the seal anchorin a sealing relation therewith.

The seal anchor may define a circumferential groove dimensioned andconfigured to receive one of the proximal, intermediate, and distalrings. The proximal ring may have a kidney-shaped cross-section and thesleeve may be rollable about the proximal ring. The distal ring may havea diameter smaller than that of the seal anchor. The distal ring may beadapted to engage the seal anchor in a sealing relation therewith. Inparticular, the distal ring may be an O-ring. Furthermore, the O-ringmay be an inflatable balloon. In addition, the intermediate ring mayhave a kidney-shaped cross-section, in which case the proximal ring maybe adapted to engage the seal anchor in a sealing relation therewith.The proximal ring may be an O-ring.

In an embodiment, the intermediate ring may be slidably disposed on anouter surface of the sleeve. In particular, the diameters of theproximal and distal rings may be larger than that of the intermediatering. Furthermore, the intermediate ring may be adapted to engage theseal anchor in a sealing relation therewith. The proximal member mayhave a kidney-shaped cross-section. The sleeve may be rollable about theproximal ring.

The proximal, distal, and intermediate rings may be elastic. The sleevemay be made of an elastic material. The seal anchor may be acompressible material. The lumen defined in the seal anchor may bedimensioned to receive surgical instruments therethrough. At least oneof the proximal, distal, or intermediate ring may be an inflatableballoon.

In accordance with another aspect of the present disclosure, there isprovided a method of accessing an internal body cavity. The methodincludes providing a surgical access assembly including an access portand a seal anchor. In particular, the access port has a proximal ring,an intermediate ring, a distal ring, and a sleeve defining a passagetherethrough. The proximal, intermediate and distal rings areconcentrically arranged with the passage of the sleeve, and the sleeveextends between the proximal and distal rings. In addition, the sealanchor is adapted to be disposed in the access port. The method furtherincludes positioning at least one of the proximal, intermediate, anddistal rings of the access port into the body cavity, rolling the sleeveof the access port such that at least two of the proximal, distal andintermediate rings engage an internal peritoneal wall of tissue and anouter epidermal tissue, positioning the seal anchor within the accessport and introducing a surgical instrument to the body cavity throughthe seal anchor.

The sleeve may be rollable about the proximal ring. The proximal ringmay have a kidney-shaped cross-section. The distal ring may be adaptedto engage the seal anchor in a sealing relation therewith. The sleevemay be rollable about the intermediate ring, in which case the proximalring may be adapted to engage the seal anchor in a sealing relationtherewith.

In an embodiment, positioning the seal anchor within the access port mayinclude engaging at least one of the proximal, intermediate, and distalrings with the seal anchor in a sealing relation therewith. It isfurther contemplated that the method may further include insufflatingthe body cavity.

BRIEF DESCRIPTION OF THE DRAWINGS

Various embodiments of the present disclosure are described hereinbelowwith reference to the drawings, wherein:

FIG. 1 is a perspective view of a surgical access assembly in accordancewith an embodiment of the present disclosure;

FIG. 2 is a longitudinal cross-sectional view of a seal anchor of thesurgical access assembly of FIG. 1 taken along section line 2-2 of FIG.1 illustrating a longitudinally extending lumen of the seal anchor;

FIG. 3 is a longitudinal cross-sectional view of a seal anchor inaccordance with another embodiment of the present disclosure;

FIG. 4 is a longitudinal cross-sectional view of a seal anchor inaccordance with still another embodiment of the present disclosure;

FIG. 5 is a longitudinal cross-sectional view of a seal anchor inaccordance with still yet another embodiment of the present disclosure;

FIG. 6 is a longitudinal cross-sectional view of an access port of thesurgical access assembly of FIG. 1;

FIG. 7 is longitudinal cross-sectional views of the access port of FIG.6 in a sealing relation with the seal anchor of FIG. 2;

FIG. 8 is a longitudinal cross-sectional view of the surgical accessassembly of FIG. 1 secured to tissue; and

FIG. 9 is a perspective view of a surgical access assembly in accordancewith another embodiment of the present disclosure;

FIG. 10 is a longitudinal cross-sectional view of an access port of thesurgical access assembly of FIG. 9;

FIG. 11 is longitudinal cross-sectional view of the access assembly ofFIG. 9 secured to tissue;

FIG. 12 is an access port in accordance with an embodiment of thepresent disclosure;

FIGS. 13 and 14 are longitudinal cross-sectional views of a surgicalaccess assembly including the access port of FIG. 12 illustratingsecurement thereof to tissue; and

FIG. 15 is a longitudinal cross-sectional view of a seal anchor inaccordance with an embodiment of the present disclosure for use with theaccess port of FIG. 12.

DETAILED DESCRIPTION OF EMBODIMENTS

Embodiments of the present disclosure will now be described in detailwith reference to the drawings, in which like reference numeralsdesignate identical or corresponding elements in each of the severalviews. As used herein, the term “distal,” as is conventional, will referto that portion of the instrument, apparatus, device or componentthereof which is farther from the user while, the term “proximal,” willrefer to that portion of the instrument, apparatus, device or componentthereof which is closer to the user. In the following description,well-known functions or constructions are not described in detail toavoid obscuring the present disclosure in unnecessary detail.

With reference to FIG. 1, there is illustrated a surgical accessassembly 10 in accordance with an embodiment of the present disclosure.Surgical access assembly 10 includes a seal anchor 100 and an accessport 1000. Access port 1000 is adapted for insertion within a tissuetract, e.g., through an opening in the abdominal or peritoneal lining,as well as a naturally occurring orifice. Access port 1000 protects theopening from, for example, infection and contamination. In addition,access port 1000 may serve to retract the opening, as will be discussedbelow. Seal anchor 100 is disposed in access port 1000 in a sealingrelation therewith to provide a substantially fluid-tight seal between abody cavity of a patient and the atmosphere. Both access port 1000 andseal anchor 100, however, may be used as a stand-alone device forinsertion of endoscopic instruments.

With continued reference to FIG. 1, seal anchor 100 is configured toreceive surgical instruments of varying diameter therethrough. Sealanchor 100 is formed from elastic/compressible type material havingsufficient compliance to form a seal about a surgical object and toestablish a sealing relation with access port 1000. Furthermore, suchmaterial enables seal anchor 100 to accommodate off-axis motion of thesurgical object extending therethrough.

Seal anchor 100 contemplates introduction of various types ofinstrumentation adapted for insertion through a trocar and/or cannulaassembly while maintaining a substantially fluid-tight interface aboutthe instrument to help preserve the atmospheric integrity of a surgicalprocedure from gas and/or fluid leakage. Examples of instrumentationinclude, but are not limited to, clip appliers, graspers, dissectors,retractors, staplers, laser probes, photographic devices, endoscopes andlaparoscopes, tubes, and the like. Such instruments will collectively bereferred to as “instruments” or “instrumentation.”

With reference now to FIG. 2, seal anchor 100 includes proximal anddistal end portions 102, 104 and an intermediate portion 106 extendingbetween proximal and distal end portions 102, 104. Seal anchor 100defines at least one lumen or channel 108 that extends longitudinallybetween proximal and distal end portions 102, 104. Proximal and distalend portions 102, 104 define substantially planar surfaces. However,proximal and distal end portions 102, 104 may define surfaces that aresubstantially arcuate to assist in the insertion of seal anchor 100within tissue. The radial dimension of intermediate portion 106 isappreciably less than those of respective proximal and distal endportions 102, 104. Under such configuration, seal anchor 100 defines anhourglass shape or profile to assist in anchoring seal anchor 100 withintissue when seal anchor 100 is used as a stand-alone device.

Seal anchor 100 is adapted to transition from an expanded condition to adeformed condition to facilitate insertion and securement of thesurgical instruments in tissue. Seal anchor 100 is formed of abiocompatible compressible material that facilitates the resilient,reciprocal transitioning of seal anchor 100 between the expanded anddeformed conditions thereof. Seal anchor 100 is biased to the initialcondition, and thus in the absence of any force applied to seal anchor100, seal anchor 100 is in the expanded condition.

Lumen 108 is configured to removably receive a surgical object “I” (FIG.8). Prior to the insertion of surgical object “I,” lumen 108 is in afirst state in which lumen 108 defines a first or initial dimension thatsubstantially prevents escape of insufflation gas through lumen 108 inthe absence of surgical object “I.” Upon insertion of surgical object“I” through lumen 108, lumen 108 transitions to a second state in whichlumen 108 defines a second, larger dimension that substantiallyapproximates the diameter of surgical object “I” such that asubstantially fluid-tight seal is formed with surgical object “I.” Inparticular, the compressible material comprising seal anchor 100facilitates the resilient transitioning of lumen 108 between its firststate and its second state. An example of a seal anchor is disclosed ina commonly assigned U.S. patent application Ser. No. 12/939,204, filedon Nov. 4, 2010, the entire contents of which are fully incorporatedherein by reference.

With reference now to FIG. 3, a seal anchor 200 in accordance with anembodiment of the present disclosure is illustrated. In the interest ofbrevity, the present embodiment will focus on the differences betweenthe previously described seal anchor 100 and seal anchor 200. Sealanchor 200 includes proximal and distal end portions 202, 204 and anintermediate portion 206 extending between proximal and distal endportions 202, 204. Proximal and distal end portions 202, 204 definesubstantially planar surfaces. Intermediate portion 206 defines a lumen208 extending therethrough. In contrast to seal anchor 100, seal anchor200 defines a circumferential groove 250 in intermediate portion 206. Inparticular, circumferential groove 250 is adjacent proximal end portion202 of seal anchor 200. Circumferential groove 250 engages access port1000 and facilitates sealing relation and securement therewith, as willbe described in detail hereinbelow.

It is further contemplated that a circumferential groove 250 may bedefined at any longitudinal position along a length of intermediateportion 206. For example, a seal anchor 300 may define a circumferentialgroove 350 in an intermediate portion 306 adjacent a distal end portion304, as illustrated in FIG. 4. In addition, it is further envisionedthat a seal anchor 400 may define a plurality of circumferential grooves450 along a length of intermediate portion 406, as shown in FIG. 5.

With particular reference now to FIG. 6, access port 1000 includes adistal ring 1020, a proximal ring 1030, an intermediate ring 1050, and aflexible sleeve 1010 defining a passage therethrough. Distal, proximaland intermediate rings 1020, 1030, 1050 are concentrically arranged andare longitudinally connected to sleeve 1010.

Distal, proximal and intermediate rings 1020, 1030, 1050 are formed ofrelatively flexible materials to facilitate compression and expansion ofdistal, proximal, and intermediate rings 1020, 1030, 1050. For example,distal, proximal, and intermediate rings 1020, 1030, 1050 may be madefrom an elastomer such as polyurethane, polyethylene, silicone, and thelike. The resilient nature of distal, proximal, and intermediate rings1020, 1030, 1050 allows distal, proximal, and intermediate rings 1020,1030, 1050 to return to their normal, substantially annularconfiguration.

In particular, proximal and intermediate rings 1030, 1050 are adapted toengage the walls defining the body cavity. Intermediate ring 1050engages the internal peritoneal wall T_(I), and proximal ring 1030engages the outer epidermal tissue T_(O) (FIG. 8). Distal ring 1020 isadapted to engage intermediate portion 106 of seal anchor 100 in asealing relation therewith. Thus, in order to provide a fluid-tight sealagainst intermediate portion 106 of seal anchor 100, distal ring 1020may have a diameter smaller than that of intermediate portion 106. Inaddition, distal ring 1020 is adapted and dimensioned to be disposed incircumferential groove 250, 350, 450 of seal anchors 200, 300, 400 toimprove securement therewith.

Sleeve 1010 has elastomeric properties to facilitate securement ofaccess port 1000 to the incision. Proximal ring 1030 is rollable togather flexible sleeve 1010 around proximal ring 1030. For example,proximal ring 1030 is rollable, e.g., in the outward direction (as shownby arrow “X” in FIG. 6) to shorten sleeve 1010 and in the inwarddirection to lengthen the sleeve 1010, or vice versa. Sleeve 1010 may beshortened such that proximal ring 1030 engages the outer epidermaltissue T_(O) adjacent the incision in tissue “T,” and intermediate ring1050 positioned in the body cavity engages the internal peritoneal wallT_(I) (FIG. 8). In this manner, access port 1000 is securely fixed totissue “T.”

With continued reference to FIG. 6, proximal ring 1030 has akidney-shaped cross-sectional profile. Kidney-shaped cross-sectionfacilitates rolling of sleeve 1010 about proximal ring 1030 and inhibitsunrolling of sleeve 1010 over proximal ring 1030 by providing aflattened edge disposed on the outer epidermal tissue T_(O).Intermediate and distal rings 1050, 1020, on the other hand, may be anO-ring having a circular cross-section. However, other cross-sectionalprofiles are also contemplated for proximal, intermediate, and distalrings 1030, 1050, 1020. It is also envisioned that the O-ring may be aninflatable balloon.

In addition, proximal and intermediate rings 1030, 1050 can vary insize. For example, the dimensions of proximal and intermediate rings1030, 1050 may be selectively chosen to be greater than that of adesired opening, as shown in FIG. 8. In this manner, proximal andintermediate rings 1030, 1050 may have sufficient footing to maintainelastic sleeve 1010 that has been stretched and retained at a distancegreater than the natural distance.

By having dimensions of proximal and intermediate rings 1030, 1050larger than that of the desired the opening in tissue “T,” access port1000 is adapted to dilate the opening to a desired dimension. Moreretraction is possible through shortening of sleeve 1010 by rollingproximal ring 1030 outward, in the direction of arrow “X,” while lessretraction is possible by rolling proximal ring 1030 inward.

In use, the peritoneal cavity (not shown) is insufflated with a suitablebiocompatible gas such as, e.g., CO₂ gas, such that the cavity wall israised and lifted away from the internal organs and tissue housedtherein, thereby providing greater access thereto. The insufflation maybe performed with an insufflation needle or similar device, as isconventional in the art. Either prior or subsequent to insufflation, anincision is made in tissue “T,” the dimensions of which may be varieddependent upon the nature of the procedure.

Prior to the insertion of access port 1000 within tissue, distal andintermediate rings 1020, 1050 are pulled proximally through proximalring 1030, as shown in FIG. 7. At this time, distal ring 1020 ispositioned around intermediate portion 106 of seal anchor 100. Distalring 1020 having a smaller diameter than that of intermediate portion106 of seal anchor 100 provides a sealing relation therewith. (Asdiscussed hereinabove, seal anchors 200, 300, 400 may be used in placeof seal anchor 100, in which case distal ring 1020 is disposed incircumferential groove 250, 350, 450 of seal anchors 200, 300, 400 tofacilitate securement thereof with seal anchor 200, 300, 400).

Access port 1000 is in its expanded condition which inhibits theinsertion thereof into tissue tract. To facilitate insertion, the usertransitions intermediate and distal rings 1050, 1020 into the compressedcondition by, e.g., squeezing intermediate and distal rings 1050, 1020,along with distal end portion 104 of seal anchor 100. Intermediate anddistal rings 1050, 1020, along with a portion of seal anchor 100 areinserted through proximal ring 1030 and into the opening in tissue “T.”Subsequent to its insertion, distal and intermediate rings 1020, 1050are disposed beneath tissue “T.”

At this time, proximal ring 1030 may be rolled in the direction of arrow“X,” as shown in FIG. 6, such that intermediate ring 1050 engages theinternal peritoneal wall T_(I) and proximal ring 1030 engages the outerepidermal tissue T_(O) to secure access port 1000 within the opening intissue “T,” as shown in FIG. 8. Depending on the nature of the procedurebeing performed, the opening in tissue “T” may be retracted by rollingsleeve 1010 about proximal ring 1030. At this time, proximal ring 1030engages the outer epidermal tissue T_(O) in a sealing relationtherewith, and intermediate ring 1050 engages the internal peritonealwall T_(I) in a sealing relation therewith. A portion of sleeve 1010that connects distal and intermediate rings 1020, 1050 provides asubstantially fluid-tight seal between the body cavity of the patientand the atmosphere, as shown in FIG. 8.

Prior to the insertion of surgical object “I,” lumen 108 defines a firstor initial dimension that substantially prevents escape of insufflationgas through lumen 108 in the absence of surgical object “I.” Uponinsertion of surgical object “I” through lumen 108, lumen 108transitions to a second state in which lumen 108 defines a second,larger dimension that substantially approximates the diameter ofsurgical object “I” such that a substantially fluid-tight seal is formedwith surgical object “I.”

One or more surgical objects “I” may be inserted through lumen 108 ofseal anchor 100. With surgical instruments “I” inserted through lumen108 and into the body cavity of the patient, the user may swivel orrotate surgical instrument “I” to a desired orientation with respect totissue “T.” At this time, access assembly 10 provides a fluid-tight sealbetween a body cavity of a patient and the atmosphere. During thesurgical procedure, surgical instrument “I” and seal anchor 100 may beremoved from access port 1000, to enable passage of the surgeon's handthrough the opening in tissue “T” to access the body cavity of thepatient, if needed. Distal ring 1020 may surround, e.g., the arm of thesurgeon, to provide a fluid-tight seal against the arm. Upon completingthe surgical procedure, the user may remove the surgical access assembly10 from the incision of the patient.

With reference now to FIGS. 9-11, an access assembly 20 in accordancewith still another embodiment of the present disclosure is illustrated.In the interest of brevity, the present embodiment will focus on thedifferences between access assembly 20 and the previously describedaccess assembly 10. Access assembly 20 includes an access port 2000 andseal anchor 200. Access port 2000 includes a proximal ring 2050, anintermediate ring 2030, a distal ring 2020 and a flexible sleeve 2010defining a passage therethrough. Proximal, intermediate and distal rings2050, 2030, 2020 are concentrically arranged and are longitudinallyconnected to sleeve 2010.

Proximal ring 2050 is adapted to engage intermediate portion 206 of sealanchor 200. In particular, proximal ring 2050 is dimensioned to engagecircumferential groove 250 defined in intermediate portion 206 adjacentproximal end portion 202 of seal anchor 200. In order to provide anappropriate sealing relation with intermediate portion 206 of sealanchor 200, proximal ring 2050 may include a diameter smaller than thatof intermediate portion 206.

With particular reference to FIG. 10, intermediate member 2030 may havea kidney-shaped cross-sectional profile. Kidney-shaped cross-sectionalprofile facilitates rolling of sleeve 2010 about intermediate ring 2030and inhibits unrolling of sleeve 2010 over intermediate ring 2030 byproviding a flattened edge disposed on the outer epidermal tissue T_(O).Proximal and distal rings 2050, 2020, on the other hand, may each be anO-ring having a circular cross-section. However, other cross-sectionalprofiles are also contemplated for proximal, intermediate, and distalrings 2050, 2030, 2020. It is also envisioned that the O-ring may be aninflatable balloon.

In addition, intermediate and distal rings 2030, 2020 can vary in size.For example, dimensions of intermediate and distal rings 2030, 2020 maybe selectively chosen to be greater than that of the opening in tissue“T” (FIG. 11). In this manner, intermediate and distal rings 2030, 2020may have sufficient footing to maintain elastic sleeve 2010 that hasbeen stretched and retained at a distance greater than the naturaldistance. In addition, by having dimensions of intermediate and distalrings 2030, 2020 larger than that of the opening, access port 2000 isadapted to dilate the opening to a desired dimension. More retraction ispossible through shortening of sleeve 2010 by rolling proximal ring2030, e.g., outward, while less retraction is possible by rollingproximal ring 2050, e.g., inward.

In contrast to access port 1000, intermediate and distal rings 2030,2020 of access port 2000 provide securement against tissue “T.”Specifically, intermediate ring 2030 engages the outer epidermal tissueT_(O) adjacent the incision in tissue “T,” and distal ring 2020positioned in the body cavity engages the internal peritoneal wallT_(I). Proximal ring 2050 engages intermediate portion 206 of sealanchor 200 to provide a fluid-tight seal therewith. In further contrastto access port 1000, a portion of sleeve 2010 that connects proximalring 2050 and intermediate ring 2030 to provide a fluid-tight sealbetween a body cavity of a patient and the atmosphere is exposed to theatmosphere. Proximal ring 2050 providing a fluid-tight seal againstintermediate portion 206 of seal anchor 200 is exposed to the atmosphereand is out of the body cavity. Such configuration enables the user toeasily adjust the position of proximal ring 2050 with respect tointermediate portion 206 of seal anchor 200. The use and operation ofaccess port 2000 is substantially similar to that of access port 1000discussed hereinabove, and thus will not be described herein.

With reference now to FIGS. 12-15, an access port 3000 in accordancewith another embodiment of the present disclosure is illustrated. In theinterest of brevity, the present embodiment will focus on thedifferences between access port 3000 and the previously described accessports 1000, 2000. Access port 3000 includes a proximal ring 3030, anintermediate ring 3040, a distal ring 3020 and a flexible sleeve 3010defining a passage therethrough. Proximal, intermediate and distal rings3030, 3040, 3020 are concentrically arranged with respect to the passageof sleeve 3010. Sleeve 3010 extends between proximal ring 3030 anddistal ring 3020 and is attached thereto. Intermediate ring 3040 isslidably disposed around an outer surface of sleeve 3010 betweenproximal and distal rings 3030, 3020.

In particular, proximal ring 3030 may have kidney-shaped cross-sectionalprofile. Kidney-shaped cross-sectional profile facilitates rolling ofsleeve 3010 about proximal ring 3030 and inhibits unrolling of sleeve3010 over proximal ring 3030. Proximal ring 3030 is adapted to engagethe outer epidermal tissue T_(O), and a distal ring 3020 is adapted toengage the internal peritoneal wall T_(I) (FIG. 14). Intermediate ring3040 is adapted to provide a fluid-tight seal against sleeve 3010 andseal anchor 100. Intermediate ring 3040 may be disposed beneath tissue“T” (as illustrated in FIG. 14) or may be exposed to the atmosphere.

The diameter of intermediate ring 3040 is smaller than that of proximaland distal rings 3030, 3040 to slidably retain intermediate ring 3040between proximal and distal rings 3030, 3040 on the outer surface ofsleeve 3010. Furthermore, the diameter of intermediate ring 3040 may besmaller than that of intermediate portion 106 of seal anchor 200 tofacilitate fluid-tight seal against seal anchor 100.

The dimensions of proximal and distal rings 3030, 3020 is selectivelychosen to be greater than that of the opening in tissue “T” (FIG. 14).In this manner, proximal and distal rings 3030, 3020 may have sufficientfooting to maintain elastic sleeve 3010 that has been stretched andretained at a distance greater than the natural distance. In addition,by having dimensions of proximal and distal rings 3030, 3020 larger thanthat of the desired working channel, access port 3000 is adapted todilate the opening to a desired dimension. More retraction is possiblethrough shortening of sleeve 3010 by rolling proximal ring 3030 outward,while less retraction is possible by rolling proximal ring 3030 inward.

In contrast to access ports 1000, 2000, access port 3000 providesslidably adjustable intermediate ring 3040. While FIGS. 13 and 14illustrate intermediate ring 3040 disposed on intermediate portion 106adjacent distal end portion 104 of seal anchor 100, intermediate ring3040 may be adjustably disposed along any longitudinal position alongintermediate portion 106 of seal anchor 100.

With reference now to FIG. 15, there is shown a seal anchor 500 for usewith access port 3000. It is contemplated that seal anchor 500 mayinclude an intermediate portion 506 defining a plurality ofcircumferential grooves 550 in tandem (FIG. 15). Each circumferentialgroove 550 is dimensioned and configured to receive thereinlongitudinally adjustable intermediate ring 3040. Intermediate ring 3040may engage, for example, circumferential groove 550 defined adjacent aproximal end portion of seal anchor 500. The use and operation of accessport 3000 is substantially similar to that of access ports 1000, 2000discussed hereinabove. Thus, the operation and use of access port 3000will not be discussed herein in the interest of brevity.

Although the illustrative embodiments of the present disclosure havebeen described herein with reference to the accompanying drawings, theabove description, disclosure, and figures should not be construed aslimiting, but merely as exemplifications of particular embodiments. Itis to be understood, therefore, that the disclosure is not limited tothose precise embodiments, and that various other changes andmodifications may be effected therein by one skilled in the art withoutdeparting from the scope or spirit of the disclosure.

1. (canceled)
 2. A surgical access assembly comprising: an access port including a proximal ring, an intermediate ring, a distal ring, and a sleeve defining a passage therethrough, the sleeve extending between the proximal and distal rings, the proximal ring having a non-circular cross-section; and a seal anchor adapted to be at least partially disposed in the access port, the seal anchor defining a lumen therethrough, at least one of the proximal, intermediate, or distal rings configured to engage the seal anchor in a sealing relation therewith, the seal anchor having a diameter larger than a diameter of the distal ring, the seal anchor dimensioned to be received through the proximal and intermediate rings.
 3. The surgical access assembly according to claim 2, wherein the distal ring is configured to engage the seal anchor in a sealing relation.
 4. The surgical access assembly according to claim 2, wherein at least one of the distal or intermediate rings is an O-ring.
 5. The surgical access assembly according to claim 4, wherein the O-ring is an inflatable balloon.
 6. The surgical access assembly according to claim 2, wherein the seal anchor defines an hourglass shape.
 7. The surgical access assembly according to claim 2, wherein at least one of the proximal, distal, or intermediate rings is elastic.
 8. The surgical access assembly according to claim 2, wherein the proximal ring has a kidney-shaped cross-section.
 9. The surgical access assembly according to claim 2, wherein the sleeve is rollable about the proximal ring.
 10. The surgical access assembly according to claim 2, wherein the sleeve is formed of an elastic material.
 11. The surgical access assembly according to claim 2, wherein the seal anchor is formed of a compressible material.
 12. The surgical access assembly according to claim 2, wherein the lumen of the seal anchor is dimensioned to receive a surgical instrument therethrough.
 13. The surgical access assembly according to claim 2, wherein at least one of the proximal, distal, or intermediate rings is an inflatable balloon.
 14. The surgical access assembly according to claim 2, wherein the seal anchor defines a circumferential groove dimensioned to receive one of the proximal, intermediate, or distal rings.
 15. A surgical access assembly comprising: an access port including a proximal ring, an intermediate ring, a distal ring, and a sleeve defining a passage therethrough, the sleeve extending between the proximal and distal rings, the intermediate ring having a non-circular cross-section, the access port configured to be supported on tissue positioned between the intermediate and distal rings; and a seal anchor adapted to be at least partially disposed in the access port, the seal anchor defining a lumen therethrough, wherein the proximal ring is configured and dimensioned to engage the seal anchor in a sealing relation therewith, the seal anchor having a diameter larger than a diameter of the proximal ring, the seal anchor dimensioned to be received through the intermediate and distal rings.
 16. The surgical access assembly according to claim 15, wherein the proximal ring is adapted to engage the seal anchor in a sealing relation.
 17. The surgical access assembly according to claim 15, wherein the proximal ring is an O-ring.
 18. The surgical access assembly according to claim 15, wherein at least one of the proximal, distal, or intermediate rings is elastic.
 19. The surgical access assembly according to claim 15, wherein the intermediate ring has a kidney-shaped cross-section.
 20. The surgical access assembly according to claim 15, wherein the sleeve is formed of an elastic material.
 21. The surgical access assembly according to claim 15, wherein the seal anchor is formed of a compressible material.
 22. The surgical access assembly according to claim 15, wherein the seal anchor defines a circumferential groove configured to receive the proximal ring.
 23. The surgical access assembly according to claim 15, wherein the intermediate ring is configured to engage an outer epidermal tissue, and the distal ring is configured to engage an internal peritoneal wall.
 24. A surgical access assembly comprising: an access port having a proximal ring, a distal ring, and an intermediate ring disposed between the proximal and distal rings, one of the proximal, intermediate, and distal rings having a non-circular cross-section; a sleeve extending between the proximal and distal rings, the sleeve defining a passage therethrough; and a seal anchor adapted to be at least partially disposed in the access port, the seal anchor defining a lumen therethrough, wherein one of the proximal, intermediate, and distal rings is configured and dimensioned to engage the seal anchor in a sealing relation therewith, a portion of the seal anchor having a diameter larger than a diameter of one of the proximal, intermediate, and distal rings, the seal anchor dimensioned for insertion through two of the proximal, intermediate, and distal rings. 